Eligibility

As a newly hired employee of A.I.S.D., you will be eligible for all benefits beginning on the first of the month following 28 days after the first day of employment. For example, if you start your new position on August 15, your benefits would begin on October 1.

Dependent Eligibility Verification

The definition of a dependent with respect to insurance is as follows:

The participant’s legal spouse who is a resident of the same country in which the participant resides. Such spouse must have met all requirements of a valid marriage contract in the state of marriage of such parties. A marriage license or common law certificate may be required.

The participant’s child who meets all of the following conditions:

Is a resident of the same country in which the participant resides;

Is unmarried or married;

Is a natural child, stepchild, legally adopted child, for whom legal adoption proceedings have been initiated if such child has been placed in your home, or a child who has been placed under the legal guardianship of the participant. A natural child qualifies as a dependent at the time of birth. A natural child means a child that is related by birth and is not an adopted child, a step-child, a foster child, niece, nephew or grandchild.

A participant’s child who is less than 26 years of age. The age requirement is waived for any mentally retarded or physically handicapped child, provided that the child is incapable of self-sustaining employment and is chiefly dependent upon the participant for support and maintenance. Proof of incapacity must be furnished to the company, and additional proof may be requested from time to time.

As required by the federal Omnibus Budget Reconciliation Act of 1993, any child of a plan participant who is an alternate recipient under a Qualified Medical Child Support Order (QMCSO) and has a right to enroll in the plan as a dependent of a participant.

Those situations specifically excluded from the definition of a dependent are:

A spouse who is legally separated or divorced from the participant. Such spouse must have met all requirements of a valid separation or divorce contract in the state granting such separation or divorce;

Any person on active military duty;

Any person eligible for coverage under this plan as an individual participant;

Any person who is covered as a dependent by more than one participant with A.I.S.D.